The urgency with respect to palliative radiotherapy treatment can be very time sensitive with respect to scheduling routine CT simulation scans to deliver treatment. However this article suggests that CT-simulation free radiotherapy treatments are highly feasible. Notably, it allowed for a statistically significant lower time to plan generation and was dosimetrically acceptable. This helps in the treatment of patients significantly. Find the article attached here (https://www.advancesradonc.org/article/S2452-1094(22)00197-X/fulltext).
This article speaks about the potential unintended consequences of giving financial incentives for residents of countries to participate in prosocial health measures. In this study they reject that by offering financial incentives to complete prosocial health measures that negative consequences materialize. What are your thoughts on this concept from a social and ethical perspective. Find the article here (https://www.nature.com/articles/s41586-022-05512-4).
This cohort study demonstrated in 313 499 Canadian adults newly diagnosed with cancer in 2016 to 2020, those diagnosed during the pandemic were less likely to receive surgery as an initial treatment and were more likely to receive chemotherapy or radiation first during the first postdiagnosis year. Mean wait times decreased in the pandemic for each modality among those who were treated within 6 months. This is very interesting and suggests that surgical procedures may be the bottleneck or time draining factor in cancer care in Canada. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800159).
The treatment for vestibular schwannoma with stereotactic radiosurgery is extremely meticulous. Therefore it was very interesting to see in this article a specialist-based consensus of cochlear contouring to be used in patients undergoing stereotatic radiosurgery (SRS) treatment for vestibular schwannoma (VS). The suggested guideline is an easily reproductive tool that allows radiation oncologists to accurately contour the vestibulocochlear system to avoid toxicity due to inadequate dosimetry of organs at risk (OAR). Extremely interesting and much needed tool for a commonly treated benign malignancy. Find the article here ()https://www.advancesradonc.org/article/S2452-1094(22)00276-7/fulltext).
PSMA PET/CT is increasingly being utilized in the treatment of prostate caner. This Phase 2 randomized control trial across multiple institutions aimed to assess the safety and efficacy of guided intensification of radiotherapy in select groups of patients. Data demonstrated that SMA-PET/CT led to intensification of RT in over half of patients (52.0%), with minimal intensification of systemic therapy (4.0%). With a median follow-up of 12.9 months, this intensification was associated with three attributable grade 3+ events (2.5% of patient undergoing PSMAgRT), but no difference in the rate of grade 2+ events attributable to RT compared with controls (43%, both arms). Find the article here (https://www.redjournal.org/article/S0360-3016(23)00006-8/fulltext).
The American College of Radiology (ACR) Fund for Collaborative Research in Imaging (FCRI) Grant is a one-time investment in compelling, innovative research that advances radiology practice.
Pilot or seed grant-type projects should test a new idea or help support a new area or direction of clinical radiology research. Grants may address a specific hypothesis and generate preliminary data that could be used to bolster subsequent comprehensive applications to national peer-reviewed funding agencies. The project must utilize ACR staff expertise or systems and outline a plan for future growth in science and funding.
To be invited to apply, applicants must first submit a Letter of Intent (LOI) by 5pm ET on January 31, 2023 using the LOI template attached to the RFA. Upon review of LOIs, applicants will receive a letter inviting them to submit a full application by 5pm ET on May 5, 2023.
Apply here: https://www.acr.org/Research/Clinical-Research/FCRI-Grant?utm_medium=email&utm_source=marketo&utm_content=banner&utm_campaign=crir_011223&mkt_tok=NTk4LVRSQS0yNDQAAAGJRNNXrW97Zy79bdi4Z0SK0skQqFjLbLbCchl7ce0yvDvNWF_lM1wr5yt3B1EXOfOx0Iu5hhXuiiBAhxqKu5kvj0M5GHzNgLbkUpyixpIeuF8
This article in Science highlights that a past history of diet induced obesity can lead to reprogramming of mononuclear phagocytes and predisposes to neuroinflammation. Ultimately the consequence of this is proinflammatory cytokine transcription, aggravation of pathological retinal angiogenesis, and neuronal degeneration associated with loss of visual function seen in macular degeneration. Find the article here (https://www.science.org/doi/10.1126/science.abj8894).
This is a very interesting article that delves into the importance of psychosocial support for spouses of individuals going through cancer treatment. Specifically it demonstrates in a cohort of more than 3 million individuals, 6.9% of spouses of patients with cancer developed a psychiatric disorder during follow-up, compared with 5.6% of spouses of individuals without cancer. The risk was statistically significantly increased among spouses of patients with cancer vs spouses of individuals without cancer. Suggesting that they should be included in the surveillance and counseling of patients with cancer. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800084).
Treating bulky locally advanced non-small lung cancer with definitive chemoradiotherapy has its challenges from a dosimetric standpoint. Though this retrospective study demonstrates that with two cycles of of induction ICI plus chemotherapy before definitive CRT are feasible for bulky LA-NSCLC, with significant tumor reduction and normal lung protection. It's possible that more induction strategies can be used in the future to achieve dosimetric constraints. Find the article here (https://www.redjournal.org/article/S0360-3016(22)03693-8/fulltext).
Retrospective data suggest that a low dose of nivolumab may be beneficial for patients with squamous cell carcinoma possibly in head and neck cancer. In this study, a randomized controlled trial was performed to investigate whether the addition of low-dose nivolumab to palliative metronomic chemotherapy improves clinical outcomes. Ultimately it demonstrated the combination of low-dose nivolumab and metronomic chemotherapy improves outcomes and is an alternative standard of care for those who cannot access full-dose programmed death 1/programmed death-ligand 1 checkpoint inhibitors. Find the article here (https://ascopubs.org/doi/abs/10.1200/JCO.22.01015).
This article from Nature Immunology highlights that ammonia detoxification confers development of CD8+ memory T cells through the urea and citrulline cycles. This highlights how these pathways can be exploited for immunotherapies in cancer and other pathologies. Find the article here (https://www.nature.com/articles/s41590-022-01365-1).
This study suggests that female oncologists face difficult career choices and discriminatory practices when attempting to build a family; systemic changes are needed to ensure that women are supported and able to advance equitably within oncology. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797989).
Does this article warrant attention for women providers in all fields? Is this something that is pervasive throughout medicine? How do we facilitate support?
The optimal strategy and methodology for deciding which patients would benefit from adjuvant radiotherapy after breast conservation therapy has been debated. Recently an adjuvant Radiotherapy Intensification Classifier (ARTIC), comprising 27 genes and patient age, in three publicly available cohorts, then independently validated ARTIC for LRR in 748 patients in SweBCG91-RT was created. It was reported as the first classifier validated as predictive of benefit from RT in a phase III clinical trial with patients randomly assigned to receive or not receive RT. Find the article here (https://ascopubs.org/doi/10.1200/JCO.19.00761).
Patients with oropharyngeal cancer have the option of surgery through TORS or adjuvant radiation. However, oftentimes when patients elect to proceed with TORS surgical margins confers adjuvant radiation therapy, but to a smaller dose. This review article highlights decision making when considering these two options and nuances surrounding this decision in great detail. Find the article here (https://www.practicalradonc.org/article/S1879-8500(22)00390-3/fulltext).
I would also like to highlight "The Daily Laws: 366 Meditations on Power, Seduction, Mastery, Strategy, and Human Nature" by Robert Greene. It is a fabulous book to start the year with and gives ample self-reflection every day of the year.
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